Below we share multiple SIREN-relevant articles published since the last newsletter. For a full list, see the SIREN Evidence and Resource Library. As always, if you are aware of resources that you think should be added to the library, please send them our way.
Peer-Reviewed Articles
Awareness / Screening
Impact of Centers for Medicare & Medicaid Services Screening Mandate on Inpatient Z-Code Documentation of Social Drivers of Health Santiago C, Steele N, Lee J, et al. | Journal of General Internal Medicine
Key results: “The CMS SDOH mandate likely led to a modest growth in claims-based documentation of social risks.”
Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is "Social Drivers of Health (SDoH) Screening" Sufficient? Zielinski S, Valdez J, James J, et al. | International Journal of Environmental Research and Public Health
Key results: “52% of individuals who reported a positive ACE screen were not flagged by SDOH screening.”
Beyond the Check Box: Development of the Nutrition Health Related Social Need Assessment and Referral Tool (N-HART) Rising KL, Kemp M, Gerolamo A, et al. | Journal of General Internal Medicine
“The N-HART is a novel 13-item tool that screens for food and nutrition needs and recommends a best fit food resource type based on an individual's needs.”
Prevalence of Health-Related Social Needs: Inpatient Versus Ambulatory Pediatric Populations Muleta H, Levano S, Gabbay JM, et al. | Journal of Pediatrics
Key results: In a tertiary children’s hospital in Bronx, NY, the prevalence of unmet HRSNs was more than twice as high among hospitalized patients than among ambulatory patients (28% vs 13%).
Documentation of Adverse Social Drivers of Health in US Emergency Departments Molina MF, Cash RE, Espinola JA, Boggs KM, Camargo CA Jr, Samuels-Kalow ME | Journal of the American College of Emergency Physicians
Key results: 94% of EDs that screened for at least 1 risk factor had policies requiring documentation of screening. 24/7 social work availability was associated with greater odds of having at least 1 SDOH documentation policy.
Homeless Services Data vs Health Records to Recognize Homelessness Pita MA, McDowell CH, Ma P, et al. | JAMA Health Forum
Key results: “Homelessness was potentially missed in 64% of ED visits and 39% of admissions.”
Sub-Population Differences in Connecting to Resources to Address Social Needs Gurewich DA, Friedman H, Li M, et al. | American Journal of Preventive Medicine
Key results: Social worker navigation was more effective than a listing of generic VA resources for two groups of veterans: low income veterans who are ineligible for VA disability benefits and veterans with high comorbidities.
Language and Demographic Disparities in Social Needs and Referral Preferences in the Pediatric ED Tedford NJ, Mujahed T, Taylor IK, et al. | Academic Pediatrics
Key results: Prevalence of unmet needs was highest among Spanish-speaking caregivers. Spanish language preference, public or no insurance, Hispanic ethnicity, and non-White racial backgrounds was each associated with greater interest in referral.
Food interventions
Medically Tailored Meals: A Case for Federal Policy Action Macpherson C, Frist WH, Gillen E | Healthcare
Key results: This systematic review finds that MTMs improve health outcomes, reduce hospitalizations, and lower total cost of care, and recommends several approaches to increasing availability and utilization.
Perceived Benefit and Impact of a Health Care-Based Food Pantry: "One Stop Shop" Plencner LM, Kelty K, Demaestri S, et al. | Journal of Ambulatory Care Management
Key results: In qualitative interviews, all 23 users of the pantry reported positive impacts on household budget but limited impacts on diet and health.
Competitors Unite: A Cross-Health System Collaboration to Address Community Food Insecurity Brown R, Salazar K, Choi S, et al. | Journal of Health Care for the Poor and Underserved
Key conclusion: “Intentionally eliminating boundaries and identifying common goals between competitor health systems can create opportunities for shared learning and accelerate dissemination of evidence-based practices.”
Food Assistance Experiences of Food-Insecure Community Members in Baton Rouge, Louisiana: A Qualitative Study Dunaway C, Edomwande C, Myers CA, Apolzan JW, Davis G, Ardoin TW | Journal of Hunger and Environmental Nutrition
Key results: Participants noted the administrative complexity of SNAP and lack of awareness of other food resources as limiting their participation and mentioned strategies they used when food benefits were insufficient to meet their needs.
Medicaid policy
When State Medicaid Demonstrations End: Projected Eligibility Loss After a MassHealth Housing Support Program Transition McCann NC, Hsu HE, Ettinger de Cuba S, et al. | Health Affairs Scholar
Key results: “Among individuals enrolled (in the MassHealth Housing Support Program) from 2021 to 2024, 68% would no longer qualify under updated 2025 criteria.”
Implementation research and resources
What Do I Do When They Disclose? Responding to Intimate Partner Violence and Coercive Control in Primary Care Neil J, Giles F, Hegarty K | Australian Journal of General Practice
This paper provides guidance and a flowchart for how to respond to IPV disclosures in primary care using the World Health Organization ‘LIVES’ framework (Listen, Inquire about needs, Validate, Enhance safety and offer Support).
Expanding Implementation of a Social Determinants of Health Screening and Referral Program to Community-Based Pediatric Clinics Gibson A, Mathur M, Cavenaugh S, et al. | Academic Pediatrics
Optimizing the Collection, Integration, and Use of Health-Related Social Needs Data in the Primary Care Setting: Recommendations Derived from Key Interest-Holders LeBeau K, Bergner EM, Harris JW, et al. | Journal of Primary Care & Community Health
Examining the Social Prescription Process: Barriers, Facilitators, and the Role of Health Information Technology Haynes D, Wedlow M, Gilliam K, Pratt R, Beebe TJ | Social Science & Medicine
Patient Perspectives on Loneliness Interventions in Primary Care: A Qualitative Study Saulnier KG, Lapidos A, Jagusch J, Garland S, Harrod M, Pfeiffer PN | Psychological Services
Commentaries and Blogs
Medicaid’s Essential Investments to Address Health-Related Social Needs Pollack H | Milbank Quarterly
The Future of North Carolina’s Healthy Opportunities Pilots and What it Means for Other Medicaid Programs Considering Social Needs Programs Kenen J | Milbank Memorial Fund
From Policy to One's Plate: Washington's New Obsession with "Food Is Medicine" Davitian L | The Senior Care Pharmacist
What Else We're Reading
What’s Keeping the U.S. From Better Population Health? Berkowitz S | Diabetes Care
University of San Francisco California